George Annas and Wendy Mariner Discuss the Importance of Human Rights in Public Health in New Article
“(Public) Health and Human Rights in Practice” explains a need to focus on the human rights framework in public health.
In late 2014, Kaci Hickox, a Doctors Without Borders nurse who treated Ebola patients in Sierra Leone, returned to the US, arriving at Newark Airport. New Jersey health officials who believed Hickox had a fever ordered her immediate quarantine in a medical tent outside University Hospital in Newark, without her consent. Having tested negative for fever and Ebola, Hickox was nonetheless forced to stay in the isolation tent for eighty hours before she was finally released. Upon arriving home, she was threatened with home quarantine by Maine’s Governor and Commissioner of Health, until a judge rejected the state’s petition as unwarranted. The incident is one of many that Professors George Annas and Wendy Mariner find troubling.
In their recent article “(Public) Health and Human Rights in Practice,” published by the Journal of Health Politics, Policy and Law, Annas and Mariner discuss the relationship between public health and human rights—arguing that public health officials and policymakers should welcome and promote human rights in order to effectively protect the population’s health.
The Human Rights Framework
The human rights framework is derived from the 1948 Universal Declaration of Human Rights and its implementing treaties, conventions and guidelines, including the 2005 Universal Declaration on Bioethics and Human Rights. States assume responsibilities to respect, protect and fulfill human rights. This means not only respecting individual rights and freedoms, such as autonomy, equality, privacy, and nondiscrimination, but also protecting the population from threats posed by the private sector and other third parties. It also means providing services needed to fulfill human rights, including the human right to health.
Both the human rights framework and public health share the goal of protecting the population and promoting human welfare. In the case of the Ebola and the post 9/11 smallpox scares, however, governments often focused solely on preventing epidemics and ignored human rights. Individuals were unnecessarily harmed without affecting the spread of disease. “If you have an ethic that holds that the state is empowered to do anything that might possibly protect against any future risk, you grant the state unlimited power. It can be dangerous,” says Mariner.
Integrating the Human Rights Framework into Public Health Policy
For Annas and Mariner, ethical controversies in public health arise not from public health’s goals, but from some of its methods, such as quarantine. Because public health relies on law to achieve its goals, they write, ethical principles governing public health must be consistent with the broader set of principles that define the power and limits of government institutions.
The human rights framework, according to Annas and Mariner, offers a set of principles that encourage a productive and integrated approach to analyzing health policy. “It pays attention to providing services and opportunities that only government can provide,” says Mariner. “It ensures that the government and third parties don’t do things like sell products that are dangerous or damage the environment or contaminate the water supply, as in Flint, Michigan.”
At the same time, the human rights framework reminds government that the methods it uses to achieve policy goals must not unjustifiably limit individual freedoms. For example, public health is often better protected by policies that improve employment, income, housing, and the environment than laws that force individuals to submit to medical treatment or quarantine.
The human rights framework is a valuable tool for policymakers to effectively protect human populations and promote human welfare, both in the United States and globally.
“I think it’s critical to use concepts of human rights in discussing legal issues across national borders,” says Mariner. “Even if you have different legal systems in different countries, all people are equal and understand each other when they speak in the language of human rights.”
As William Fairfield Warren Distinguished Professor, Professor for BU Law’s health law concentration, and chair of the BU School of Public Health’s Health Law, Bioethics & Human Rights department, Annas has authored or edited 19 books on health law and bioethics. His most recent work, Genomic Messages, explains how the evolving science of genomics is changing medical care.
Professor of Law and Edward R. Utley Professor of Health Law at the School of Public Health Wendy Mariner has published articles in the legal, medical, and health policy literature, and along with Annas, co-authored the law school textbook Public Health Law. She was recently named to the Uniform Law Commission’s Study Committee on Declarations of Quarantine.
Reported by Greg Yang (CAS’17).